Refine PT and Performance - East Alabama LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REFINE PT AND PERFORMANCE - EAST ALABAMA LLC

Practice address

1324 Ross Clark Cir
Dothan, AL 36301-4117

Phone

(334) 769-2003

Fax

(334) 769-2004

NPI assigned

Apr 25, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kyle ThibodeauxNPI 1225568611

Title

Owner/Member

Phone

(256) 227-9464

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle Thibodeaux, PT, DPT

  • Physical Therapist
  • Mobile, AL
  • NPI 1225568611
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1467196451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014117",
            "telephone_number": "334-769-2003",
            "fax_number": "334-769-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014117",
            "telephone_number": "334-769-2003",
            "fax_number": "334-769-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFINE PT AND PERFORMANCE - EAST ALABAMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "THIBODEAUX",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "256-227-9464"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neeta Muddasani Reddy
• Puli Gopal Reddy, MD
• Starla Reeder, MCD, CCC/SLP
• Sydney Mims Reeder, CRNA
• Nikeli Sharell Reeves, MSW
• Kari Elizabeth Regehr
• Regenerative Medicine of Alabama
• Kaylie Elaine Register, RBT
• Sherret Register, CBD, MSN, RN
• Milan Regmi, MD

• All providers in Dothan, AL
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.